RT Book, Section
A1 Shaw, Leslee J.
A1 Charney, Pamela
A1 Wenger, Nanette K.
A2 Fuster, Valentin
A2 Harrington, Robert A.
A2 Narula, Jagat
A2 Eapen, Zubin J.
SR Print(0)
ID 1191189218
T1 WOMEN AND ISCHEMIC HEART DISEASE: AN EVOLVING SAGA
T2 Hurst's The Heart, 14e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071843249
LK accesscardiology.mhmedical.com/content.aspx?aid=1191189218
RD 2024/04/16
AB SummaryThis  chapter  discusses  ischemic  heart  disease  (IHD)  in  women.  IHD  is  the  leading  cause  of  morbidity,  mortality,  and  disability  in  US  women.  Among  all  ages,  women  have  a  lower  prevalence  of  coronary  artery  disease  (CAD)  than  do  men;  however,  once  clinical  manifestations  of  IHD  develop,  women  have  less  favourable  outcomes  than  do  their  male  peers  in  the  settings  of  stable  IHD,  acute  coronary  syndromes  (ACS),  and  coronary  revascularization.  Prevention  strategies  in  women  should  take  into  account  risk  factors  that  are  unique  or  predominant  in  women,  such  as  pregnancy  complications  and  systemic  autoimmune  disorders,  as  well  as  the  differential  risks  of  traditional  risk  factors  in  men  and  women  (see  accompanying  Hurst’s  Central  Illustration).  The  clinical  diagnosis  of  angina  can  be  challenging  in  women;  a  careful  history  is  required  to  assess  the  likelihood  of  CAD  and  to  aid  decision  making  regarding  additional  testing.  Noninvasive  diagnostic  testing  can  refine  the  management  of  symptomatic  women.  Invasive  coronary  angiography  may  be  used  as  a  frontline  procedure  in  high-risk  women  or  those  whose  symptom  burden  is  considered  unstable,  or  in  the  setting  of  demonstrable  ischemia  by  stress  testing.  Compared  with  men,  women  with  acute  or  stable  IHD  more  often  have  nonobstructive  CAD.  Women  with  IHD  are  less  likely  than  men  to  receive  guideline-based  therapy,  and  have  worse  outcomes.